Most people engage in corrective exercise programs to decrease physical symptoms of pain. The application of corrective exercise to improve body mechanics, and enhance function, is very effective ways to help achieve this objective. However, another vital element to decreasing sensations of pain must also be considered in corrective exercise programming. It is the brain; more specifically, its ability to interpret and learn from past/current (and shape future) experiences of pain (Levine, 2010). This blog will discuss features of the brain’s role in experiences of pain and discomfort. It will also highlight what you can do as a fitness professional to help both yourself and your clients when it comes to developing a pain-free mindset to overcome recurring aches and pains.
Like Father Like Son. Like Mother Like Daughter.
From the moment we are born, parts of our brain work tirelessly to learn how to communicate effectively, interact with others and the environment, and interpret the world around us. The brain picks up these skills quickly by mirroring and mimicking people of significance in our lives. Portions of our brain activate by observing our parents’ (or caregivers’) facial expressions, voice, speech patterns, dialogue content, gesture, movements, etc. (Van der Kolk, 2014). This ability to copy behaviors assists us in learning various skills necessary for safety and survival. However, it can also be devastating from a mental standpoint if your role models do not possess practical and positive strategies for dealing with experiences of pain and discomfort.
Parents or caregivers that experience recurring aches and pains and/or who dwell on experiences of pain as being negative and personal (perhaps something they learned from their parents or caregivers), can predispose their children (i.e., your clients) to developing a dysfunctional mindset when it comes to pain. A typical statement from clients who fall into this category might sound something like this: “My mother had painful bunions. That is why I have them too.” or “My father always complained about his shoulder. It runs in my family.”
Playing Broken Records
A person’s current beliefs are, in large part, a result of the little voice inside their head that interprets their experience of what is happening to them (Bandura, 1986). Clients bought up with parents/caregivers in chronic pain (especially those who escalated or catastrophized experiences of pain with negative thought patterns) learned that such reactions were an appropriate way to respond to pain and discomfort. They subsequently now apply those same overly-intensified approaches to their own experiences of pain. For example, someone with dysfunctional thinking patterns might jump to the conclusion that lower back pain felt the day following a long day of gardening must be the result of an injury or problem (like a herniated disk or sprain) rather than the fact that they have simply overexerted themselves. Such mental overreactions to physical sensations of pain affect one’s ability to relax, rest, recover and heal from overexertion (Berdik, 2012).
So how do you help retrain your client’s brain so that their mind defaults to a more positive and practical approach to resolving their ongoing experiences of pain? The short answer is to promote the development of a pain-free mindset through the use of simple breathing and visualization techniques. These strategies together can stimulate relaxation while overwriting the negative internal dialogue that accompanies sensations of pain.
Breathing Techniques for Developing a Pain-Free Mindset
Drawing breath in activates the sympathetic nervous system (i.e., our “flight and flight” responses) which causes the heart rate to rise, blood pressure to increase and the nervous system to excite. Breathing out activates the parasympathetic nervous system which slows the heart rate and allows the sphincter to relax (i.e., our “rest and recover” responses). People who are hyper-aroused from sensations of pain (or who have anxiety issues surrounding their experiences of pain) are typically shallow breathers. They never fully take a deep breath in or exhale completely. This is in part because of their ongoing pain, but also because their amplified reactions to it have left them feeling nervous and agitated. This constant state of “flight or fight” leaves the person wearied and prevents physical and mental rest and recovery. This fatigue leads to more thoughts of dread and desperation, which further alters breathing patterns and continued experiences of pain (Van der Kolk, 2014).
Retraining breathing patterns from shallow breathing to deep breathing can help change the brain’s (and body’s) involuntary (i.e., automatic) responses. Coaching clients to control their breathing (by taking long, slow, deep breaths in and out) when they experience physical sensations of pain can help them trigger a change in their nervous system and allow their system to “reset” (Sherrington, 2010).
Positive Words and Images for Developing a Pain-Free Mindset
The addition of positive affirmations and/or visualizations in combination with breathing awareness and control can also help clients change the way they experience pain. If physical sensations of pain produce thoughts that typically catastrophize the situation (e.g., thinking that they are never going to get better, believe the cause of their pain is not curable, etc.) teach them to strengthen their mindset using affirmations like, “This pain/condition is temporary. I am doing all the right corrective exercises and changing my mindset to strengthen myself and I will get better”. Work with clients to develop their own affirmations using their own vocabulary. This will empower them to visualize an alternative way of thinking and help cement these new thoughts and emotions by putting them into words (Kushner, 2009).
Imagine, for example, that you are working with a client with ongoing back pain and they suddenly feel a sharp pain in their back and begin to get anxious or panic. Instruct them to stop talking and take five long, slow deep breaths in and out. Once they have cleared their mind (and body) of stress and alarming thoughts, coach them to use positive affirmations and/or visualize an alternative present (and different future) that does not include recurring sensations of pain. Encourage them to use this strategy every time they experience pain (in their back or anywhere else) to change their initial reactions and redirect focus toward solutions to their problem (i.e., their current corrective exercise program and new positive mindset).
New habits, especially developing a new mindset takes time. Urge clients to practice these new techniques faithfully until their new way of thinking becomes habitual (Price 2018; Price, 2019). Although future sensations of pain will naturally cause a state of heightened arousal initially, the breathing techniques and positive self-talk will enable them to stabilize their mental reaction and allow these temporary sensations to pass more quickly. Circumventing these overreactions of the mind and body in the face of pain will facilitate a quicker and easier recovery from pain and/or injury both in the short and long term.
Ongoing experiences of pain (and any associated negative reactions to these feelings) can disrupt the natural healing properties of the body. Teaching clients to retrain their brain to develop better responses to sensations of pain can help decrease mental stress and allow their body to rest, recover and renew.
Bandura, A. (1986). Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall.
Berdik, C. (2012). Mind Over Mind: the Surprising Power of Expectations. New York: Penguin.
Kushner, H. (2009). Conquering Fear. New York: Anchor Books.
Levine, P. (2010). In an Unspoken Voice. How The Body Releases Trauma and Restores Goodness. Berkeley, CA: North Atlantic Books.
Price, J. 2019. The BioMechanics Method Corrective Exercise Educational Program (2nd Edition). The BioMechanics Press.
Price, J. (2018). The BioMechanics Method for Corrective Exercise. Champaign, IL: Human Kinetics.
Sherington, C. (2010). The Integrative Action of the Nervous System. New York, NY: Ayer Company.
Van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Brain in the Healing of Trauma. New York: Penguin.